Mental disorders due to psychoactive substances

Introduction Mental disorders associated with psychoactive substances (referred to as substances) can be divided into two categories: one is the use of psychoactive substances (substance dependence disorder and substance abuse), and the other is caused by psychoactive substances, including: mental Active substance poisoning, withdrawal of psychoactive substances, paralysis caused by psychoactive substances, persistent dementia caused by psychoactive substances, persistent amnesia caused by psychoactive substances, psychotic disorders caused by psychoactive substances, spirit Mood disorders caused by active substances, anxiety disorders caused by psychoactive substances, sexual dysfunction caused by psychoactive substances, and sleep disorders caused by psychoactive substances.

Cause

Etiology

The factors that cause drug addiction are not single, and are related to drug availability, genetic quality and personality susceptibility as well as sociocultural factors.

Some drug addicts, especially young people, have a certain degree of personality and moral disorder before taking the drug, such as poor academic performance, truancy or discipline. Some families have mental illness or personality disorder, or have an unpleasant experience in childhood.

Social culture has an impact on the occurrence of drug addiction. The application of addiction drugs in society is tolerant, and drug addiction is prone to flooding, such as cannabis is widely prevalent in North America. Social pressure within the group also has an impact, such as pressure between intimate partners. Medical and pharmacists get drugs late and can become a good class.

[Pathogenesis]

Mechanisms for drug dependence:

1 metabolic resistance and cell resistance. Metabolic resistance refers to the fact that the metabolic process of the drug is accelerated, the concentration in the tissue is decreased, the effect is weakened, and the effective time is shortened. Cellular drug resistance is caused by a certain adaptive change of nerve cells, so that the nerve cells can work normally only if the blood contains a high concentration of drugs. The mechanism by which this cell adapts to change is unclear.

2 Receptor theory, a morphine receptor with a specific affinity for morphine drugs and an endogenous morphine receptor agonist were found in the brain. Therefore, it is speculated that the rapid formation of drug dependence may be related to the specific affinity of exogenous morphine and morphine receptors, and the latter is blocked, resulting in a sharp increase in drug resistance.

3 The disuse sensitivity susceptibility hypothesis of withdrawal syndrome. When the morphine receptor is blocked by morphine for a long time, the drug resistance is increased. At the same time, the drug may block the receptor and cause sensitization, so that withdrawal syndrome occurs during the withdrawal.

4 biogenic amine theory. Research data demonstrate that monoamine neurotransmitters are involved in analgesic and addictive mechanisms. The rate of 5-HT renewal in the brain after injection of morphine increased with the emergence of drug resistance.

an examination

Related inspection

Brain CT examination of cranial nerve examination

Diagnostic criteria for drug dependence

1. A history of long-term or repeated use of psychoactive substances.

2. There is a strong desire and tolerance for psychoactive substances, so at least two of the following:

1 can not get rid of the desire to use this substance.

2 The will to extract this substance is significantly enhanced.

3 Always give up other activities or hobbies to use this substance.

4 Knowing that this substance is harmful, but still continue to use it, or to argue for yourself, or to use it or not, but fail or fail repeatedly.

5 experience the pleasure when using.

6 is more resistant to this substance.

7 withdrawal syndrome appeared after discontinuation.

Diagnostic criteria for withdrawal syndrome

1. Have a history of psychoactive substance dependence.

2. After discontinuing or using less dependent psychoactive substances, at least three of the following psychiatric symptoms occur:

1 emotional changes; such as anxiety, depression, irritability, irritability and so on.

2 disturbance of consciousness.

3 insomnia.

4 tired, tired of sleep.

5 exercise excitement or inhibition.

6 Attention is not concentrated.

7 memory loss.

8 judgment declines.

9 hallucinations or illusions.

10 delusions.

(11) Personality changes.

3. At least two of the following physical symptoms or signs:

1 nausea and vomiting.

2 muscles or pain in the body.

3 pupil changes.

4 runny nose or tears or yawn.

5 abdominal pain, diarrhea.

6 dry heat or elevated body temperature.

7 serious discomfort.

8 twitching.

4. The nature and severity of the symptoms depend on the type and dose of the psychoactive substance, and once again, the withdrawal syndrome can quickly disappear.

Differential diagnosis

Organic mental disorder: organic mental disorder, a group of mental disorders based on verifiable brain diseases, brain damage or other damage. The mental disorder can be primary, such as directly and selectively affecting the brain's disease, injury, and damage, or it can be secondary, such as certain systemic diseases and disorders, the brain is just multiple damaged organs. Or one of the systems. The term symptomatic mental disorder refers to the latter subgroup. See: organic psychosis.

Mental disorders caused by non-dependent substances: mental dsorders cused by nn-ependent sbstances, certain non-dependent substances such as hormones, isoniazid, benzene, organic phosphorus, etc. are derived from in vitro, Although it does not produce psychological and physiological dependence, it can affect the individual's mental state and produce psychotic symptoms, which are often confused with schizophrenia.

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